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BUILDING PERMIT APPLICANT: PROPERTY OWNER
1, Timothy Hoffman understand that the State of Minnesota requires
that all residential building contractors, remodelers and roofers obtain a state license
unless they qualify for a specific exemption from the licensing requirements. This license
requirement applies to whiners of residential real estate who build or improve such
property for purposes of speculation or resale.
By signing this document, I attest to the fact that I am improving this house for my own
use and am not building or improving this house for the purpose of reselling it.I hereby
claim to be exempt from the state ilcensingrequirements because I am not in the business
of building or remodeling on speculation or for resale and that the house for which I am
applying for this permit, located at 5570 Matterhorn Dr NE Fridley
is the only residential structure I have built or improved in the past 24 months. I also
acknowledge that because I do not have a state license, I forfeit any mechanic's lien
rights to which I may otherwise have been entitled under Minn. Stat. §514.01.
Furthermore, I acknowledge that I may be hiring independent contractors to perform
certain aspects of the construction or improvement of this house and I understand that
some of these contractors may be required to be Leer_sed by the State of Minnesota. I
understand that unlicensed residential contracting,remodeling, and/or reofLng activity is a
misdemeanor under Minn. Stat. §326B.082,subd. 16 and car.also result in a fine of up to
$10,000. I further state that I understand that the filing of a false statement with
The City of Fridley may also result in criminal prosecution and/or civil penalties
to applicable city ordinances and/or state statutes.
I have also been informed and acknowledge that by listing myself as the contractor for
this project, I alone will be responsible to The City of Fridley for compliance will
all applicable building codes and city ordinances with the work being preforme or, this
property.
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S' ire of iProPO-Y'()caner
7/18/22
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For questions or information on contractor licensin;,or to check tine licensing status and enforcement
history of a particular contractor, call the Minnesota Department of Labor and Industry,Constractior.
Codes and Licensing Division, at(651)23=1-5069.The web si.c is: httr,://,.vww.dli.mn.auv,Ccld.asn